This application is in response to the Program Announcement "Health Promotion among Racial and Ethnic Minority Males" (PA-07-421). Colorectal cancer (CRC) is a leading cause of cancer-related morbidity and mortality among Latinos despite effective screening methods. While rates of screening overall have increased, the disparities in CRC screening between non-Latino Whites and Latinos have also increased. Even after accounting for socioeconomic factors, screening rates are lower for Latinos than for non-Latino Whites suggesting that there are other factors and barriers to CRC screening that are specific to Latinos. A conceptual framework known as "positive deviance" is a particularly promising approach for addressing barriers to CRC screening among Latinos. The central premise behind positive deviance is that solutions to common problems found in a community often already exist in that community but they go unrecognized and so are underutilized. A positive deviance approach identifies behaviors associated with success and disseminates strategies for adopting these behaviors to others. When applied to CRC screening, this approach can identify specific barriers to screening as well as strategies to overcome these barriers. Video is an ideal medium for disseminating the strategies that "positive deviants" or "successful peers" use to overcome barriers to CRC screening. A positive deviance approach combined with video can thus capitalize on the screening behaviors of "successful peers" in a community and make behavioral interventions particularly relevant and culturally appropriate to others in that community. The purpose of this proposal is to explore barriers to CRC screening encountered by Spanish-speaking Latino men, identify successful strategies used by successful peers to overcome barriers and in so doing, use a positive deviance approach to develop a culturally and linguistically appropriate tailored video-based intervention to increase CRC screening among Spanish-speaking Latino men.
Colorectal cancer screening rates are low, especially among Latinos with limited English proficiency. "Positive deviants" or "successful peers" are those individuals in a community who practice a healthy behavior (e.g. colorectal cancer screening) when the majority do not. This project will use a "positive deviance" approach to create a culturally and linguistically appropriate innovative personalized video intervention to promote colorectal cancer screening among Spanish-speaking Latino men.